The initial event in heart attacks is a plaque rupture. Atherosclerotic plaques are deposits of fatty material in the walls of arteries with thin membranes over them that can rupture (break open) causing a thrombus or blockade of the vessel. The likelihood of this rupture is much greater with inflammation. Fish oil, aspirin, lisinopril and lovastatin, all of which decrease inflammation, have been shown to significantly reduce stroke and heart attack rates.
Aspirin does have bleeding side effects and some caution is warranted if you don't have significant risk factors for heart attacks or strokes.
Fish oil may protect against strokeAspirin Therapy: Right for Your Heart? An inexpensive combination of one drug to lower cholesterol and one to lower blood pressure can reduce the incidence of heart attacks and strokes by as much as 60% -- but getting patients to begin the regimen and then to stay on it is an extremely difficult task, Kaiser Permanente researchers reported Thursday.
The Kaiser team chose two generic drugs, lovastatin for cholesterol and lisinopril for blood pressure, and offered them to 170,000 members of their managed-care programs in Northern and Southern California who suffered from heart disease or diabetes.
They began the program in 2004 with nearly 70,000 patients. The team monitored compliance for two years by checking whether and how often patients refilled their prescriptions, then monitored health effects in the third year through the patients' health records...47,268 patients ...termed "low exposure" to the drugs, taking them less than half the time...risk of hospitalization for heart attack or stroke was lowered by 15 events per 1,000 person-years..."high exposure" to the drugs, taking them more than half the time...risk was reduced by 26 events per 1,000 person-years...
"What was fairly amazing to me was that we got such a good drop in heart attack and strokes" despite the low adherence, Dudl said. "The issue now is how to increase adherence."
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